File by Dec. 16 to avoid Medicare pay cut of 2-4 percent

Practices that may have thought they were safe from Medicare payment penalties next year could be in for an unpleasant surprise if they don’t take action now.

Problems with how the Centers for Medicare & Medicaid Services (CMS) has been collecting and analyzing data related to the Physician Quality Reporting System (PQRS) and the value-based payment modifier are leading to inappropriate penalties of 2-4 percent of Medicare payments for thousands of physicians.

Estimates place the number of those who will see a payment cut at no less than one-quarter of Medicare participating physicians—and that figure includes many practices that have successfully participated in quality reporting programs in the past. Payment cuts for 2016 are based on data from the 2014 reporting period.

How to avoid the penalty

File an informal review request with CMS before midnight Eastern time Dec. 16. CMS has said it will verify incentive eligibility and payment adjustment determinations for practices that file such a request. Practices will be contacted by email within 90 days of filing.

Additional information about the process is available in CMS’ informal review fact sheet. And questions regarding the informal review process can be directed to the QualityNet Help Desk at [phone] or [e-mail], Monday-Friday from 8 a.m. to 8 p.m. Eastern time.

Note: CMS has said the informal review system will be down Dec. 3-7 and unable to accept requests during that time.

T...

Source: AMA Wire - December 2, 2015 Category: Journals (General) Authors: Amy Farouk Source Type: news